OB/GYNs

OB/GYN Medical Malpractice Insurance: How to Align Your Liability Coverage with Abortion Legislation

2024-11-06T16:23:18+00:00

Recent shifts in state and federal abortion legislation have significantly impacted the practice of obstetrics and gynecology (OB/GYN) in the United States. At the intersection of healthcare and law, OB/GYNs must navigate a complex landscape to minimize liability while delivering safe, compliant care. This evolving regulatory environment shapes medical malpractice and access to care, highlighting the need for robust malpractice insurance.

This article examines the impact of abortion legislation on OB/GYNs and offers six key malpractice insurance considerations to protect against liability risks. Consider these policy features to safeguard your practice and minimize liability exposure.

How Recent Abortion Legislation Creates Challenges for OBGYNs

In 2022, the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade, ending federal protection of abortion rights and returning regulations to individual states.

As a result, abortion laws vary significantly across the country. While some states maintain broad access, others have instituted abortion bans or restrictive measures. These restrictions may include mandatory counseling, ultrasound requirements, or waiting periods before an abortion can be performed, creating a complex and varied legal landscape for reproductive care in the U.S.

A disjunct legal environment presents many challenges for OB/GYNs, including:

  • Clinical Implications
    Restrictions on abortion services extend beyond elective procedures, influencing treatment plans for ectopic pregnancies, miscarriage management, and other cases where pregnancy termination is medically necessary.OB/GYNs face the complex dichotomy of managing clinical practices, treatments, and medications that comply with the medical standards of care without violating state and federal law.
  • Legal Ambiguity
    Lack of awareness about current abortion laws is not a defense against legal or liability claims, making it crucial for physicians to stay up-to-date on federal or state regulations affecting obstetric and gynecological restrictions or standards of care.
  • Internal Conflict
    Some physicians might struggle with their state’s stance on abortion and how it contextualizes the patient-provider relationship or their professional obligation to provide zero-harm, evidence-based care.
  • Risk Factor
    As a high-risk medical specialty, OB/GYN practices may see their risk profiles reevaluated by insurers, considering the new complexities introduced by state-mandated maternal and fetal health regulations.

Abortion Laws Impact OB/GYN Practices & Patient Access to Care

The reversal of Roe v Wade and subsequent patchwork of state abortion laws can impact how and where OB/GYNs choose to provide reproductive care. Restrictive abortion laws can increase liability exposure for physicians while complicating healthcare access for some patients. As such:

  • OB/GYN shortages are more substantial in states that prohibit abortion.
    According to a 2024 report released by the maternal and infant health non-profit March of Dimes, 1 in 3 U.S. counties lack obstetric physicians to provide care, and states that prohibit abortion have fewer OBGYNs for every 10,000 births in comparison to states where abortion is less regulated.
  • Patients are crossing state lines for OB/GYN care.
    Because legal jurisdiction is established based on the patient’s location, OB/GYNs who treat out-of-state patients can be exposed to additional liability risks. Providers must comply with the state laws of the patient’s state and the state(s) that issued their medical license. This becomes particularly important regarding state-specific definitions of informed consent, a common driver of medical malpractice claims.
  • Telemedicine allows OB/GYNs to treat patients in multiple states.
    Medication abortions can be prescribed remotely via telemedicine, allowing OB/GYNs to offer consultations and prescription services in restrictive states. However, significant legal and malpractice implications must be considered:

    • OB/GYN must be licensed in the state where the patient is located during the consultation.
    • Medication abortion prescriptions are subject to additional federal & state regulations.
    • Informed consent requirements for the patient AND provider must be met to adhere to standards of care.

How Medical Malpractice Insurance Can Protect OB/GYNs Against Regulatory Changes

Given the frequent and unpredictable nature of legislative changes, it is crucial that OB/GYNs proactively manage their medical malpractice insurance to ensure adequate protection.

These considerations can help reduce liability exposure for you & your practice:

  1. Review Insurance Coverage Details
    OB/GYNs should carefully review their current medical malpractice policy to understand exactly what is or isn’t covered by the insurance provider, particularly regarding abortion services and telemedicine. Some policies contain exclusions for specific procedures or treatments, so ensure all your practice offerings are covered.

    • Policy Limits: With the potential for significant financial damages in lawsuits related to pregnancy and abortion services, higher policy limits may be advisable.
    • Telemedicine Coverage: Confirm that the malpractice insurance policy explicitly covers remote telemedicine services, including interstate consultations and medications.

With a SURGPLI broker as your single point of contact , OB/GYNs can save time and effort comparing a wide range of policies, carriers, and rates.

  1. Evaluate Policy Endorsements & Riders
    For extra protection and peace of mind, consider adding an endorsement or rider to a new or existing policy that explicitly covers telemedicine services and/or out-of-state practice, depending on your location and services.

    • Criminal Defense Coverage: In some states, under certain circumstances, performing an abortion may carry criminal penalties. Medical malpractice policies don’t typically cover criminal defense, but some insurers offer an optional rider or endorsement covering criminal defense costs.
  2. Select an A.M. Best A-Rated Carrier
    A-rated medical malpractice insurance companies have a strong reputation for financial stability and legal representation for policyholders in lawsuits. Focus on insurance providers specializing in medical malpractice for OB/GYNs, understanding the risks associated with reproductive healthcare.
  3. Legal Support
    Choose a policy that offers robust legal support in the event of a claim or lawsuit, specifically for legal defense against alleged violations of state abortion laws and disciplinary actions by state medical boards.
  4. Planning to Relocate?
    If you’re considering moving your practice to a new state, tail insurance can help you avoid gaps in coverage and protect against future claims that might arise from care delivered at your original location.
  5. Stay Informed
    Keep yourself up-to-date on any changes in state laws or malpractice insurance regulations. Continuing medical education (CME) seminars focused on reproductive health and/or malpractice risk management can support this effort.

Prepare Today for the Legislation of Tomorrow

By securing comprehensive medical malpractice coverage and understanding the legal implications of treating patients across state lines, OB/GYNs can deliver quality women’s health and reproductive care while minimizing legal and professional liability.

SURGPLI brokers specialize in securing robust coverage for OB/GYN physicians and surgeons in high-risk specialties who are often targets for medical malpractice lawsuits

Will your current malpractice policy be enough if your state reverses or passes new legislation on abortion?

Find out now by contacting a SURGPLI broker for a free consultation & quote, or call us at 800-969-1339.

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OB/GYN Medical Malpractice Insurance: How to Align Your Liability Coverage with Abortion Legislation2024-11-06T16:23:18+00:00

OB/GYN Specialists: How to Proactively Manage Malpractice Risk

2024-02-29T00:00:25+00:00

Gynecologists and obstetricians are dedicated to providing quality preventative and critical care for female-specific health conditions at every stage of a woman’s life — and ensuring the health and safety of expectant mothers and their newborns throughout pregnancy and at delivery.

Because of the high-risk nature of gynecological illnesses and pregnancy complications, OB/GYN specialists are especially challenged to avoid any misdiagnoses, procedural errors, or mismanagement of post-op patients that could lead to allegations of medical malpractice. As an OB/GYN physician, you can reduce your risk of financial loss by securing robust malpractice insurance from an “A” rated carrier with the right coverage and rates for your OB/GYN specialty. In addition, you can benefit from having a strong risk management plan in place to potentially limit exposure to litigation while improving patient outcomes.

This article focuses on key findings from a recent study of obstetrics and gynecology malpractice cases by MedPro Group, an “A++” rated medical malpractice insurance carrier. Use this information to identify the leading malpractice allegations for your specialty, assess your risk for litigation, and develop a proactive risk management strategy.

Obstetrics: Major malpractice allegations and contributing factors

73% of the total OB malpractice cases reviewed in the MedPro study resulted in high clinical severity of patient injury, with 28% of high severity cases resulting in patient death. Overall, allegations of delay in treating fetal distress resulted in the largest share of total dollars paid to plaintiffs, as well as for the highest proportion of cases that closed with an indemnity payout. All allegations with financial severity cited in the MedPro study are ranked as follows, from most to least severe:

  • Delay in treatment of fetal distress

  • Improper management of pregnancy

  • Improper performance of vaginal delivery

  • Delay in delivery (induction/surgical)

  • Improper performance of operative delivery

  • Improperly managed labor

  • Improper choice of delivery method

  • Improper management of post-partum patient

  • Retained foreign body

The following are the top contributing factors in OB malpractice cases and the most common allegations related to each:

  • Clinical judgment

    • 96% Delay in treating fetal distress
    • 96% Improper management of pregnancy
    • 95% Improper performance of vaginal delivery

  • Technical skill

    • 79% Improper performance of vaginal delivery

  • Communication

    • 61% Delay in treating fetal distress
    • 50% Improper management of pregnancy
    • 32% Improper performance of vaginal delivery

  • Clinical environment

    • Allegations of “delay in treatment of fetal distress” were cited in nearly 50% of claims with clinical environment as a contributing factor, indicating that malpractice risk spans the continuum of OB care:

    1. Labor/delivery environment

    • Delay in the treatment of fetal distress was the top allegation among all claims in this category. Other alleged iatrogenic patient injuries included fetal encephalopathy, uterine ruptures, hemorrhaging, and infections.

    2. Ambulatory/office and clinic

    Diagnosis-related allegations were related to tubal pregnancies, underlying maternal cancers, and chromosome anomalies. Failure to recognize and address developing symptoms, delays in ordering diagnostic tests, and poor communication among providers when reporting or responding to test results were cited in these cases.

Gynecology: Major malpractice allegations and contributing factors

75% of GYN malpractice claims and 85% of total payouts were found to be triggered by incidents of improper performance of surgery, improper management of surgical patients, and poor communication leading to diagnostic delays. In 58% of the cases, allegations were described as having medium clinical severity, such as infections, drug side-effects, delayed recovery, and other non-disabling patient injuries. 36% of the cases cited patient injuries classified as high clinical severity, such as severe brain damage or other significant permanent disablement, or patient death.

The following are the top contributing factors in GYN malpractice cases and the most common allegations related to each:

  • Technical/procedural skill

    • 96% Improper performance of surgery
    • 64% Improper management of surgical patient

  • Clinical judgment

    • 94% Diagnostic-related
    • 84% Improper management of surgical patient
    • 70% Improper performance of surgery

  • Communication

    • 51% Diagnostic-related
    • 52% Improper management of surgical patient
    • 33% Improper performance of surgery

  • Improper performance of surgery

    Among allegations of improper performance of surgery, the study found that the most frequently cited surgical procedures were hysterectomy, oophorectomy, laparoscopy, and incontinence-related procedures. The most common patient injuries included: the need for additional surgery; punctures/lacerations/tears; infections; genitourinary dysfunction.

  • Improper management of surgical patient

    Common allegations in GYN cases cited the surgeon’s delay or failure to identify, manage, monitor, or prevent a developing complication — before, during, or after surgery — from becoming a serious adverse outcome.

  • Diagnostic-related allegations

    Delays in diagnosing uterine, ovarian, and breast cancers triggered allegations in two-thirds of the GYN cases. Delays in diagnosing procedural lacerations and post-op infections were also cited. Other contributing allegations included narrow diagnostic focus, inadequate patient assessment, the failure to order a consultation, and overall poor communication among providers when reporting or following up with diagnostic test results.

Build a strategy for proactive OB/GYN risk management

Based on the MedPro study findings, a proactive plan to reduce malpractice risk for OB/GYN specialists must focus on improvements in clinical decision making, procedural skills, and communication. Key recommendations from the study include:

  • Stay up to date with current and emerging OB/GYN procedural skills and techniques, especially for treating incidents of fetal distress across all phases of the pregnancy, as well as severe fetal and maternal complications during labor and delivery.

  • Improve patient communication. Ensure that OB/GYN patients give informed consent and understand the risks of the specific type of delivery method or gynecological surgery that is prescribed.

  • Emphasize communication among providers and care teams to avoid delays in diagnostic testing and reporting of test results, most critically in GYN cases involving uterine, ovarian, and breast cancers.

  • Establish “repetitive drills” and procedures to ensure that OB care teams quickly identify, respond to, and manage incidents of fetal distress and other incidents of high clinical severity.

  • Improve clinical decision-making across all OB clinical environments. Ensure that the labor and delivery team has access to the patient’s outpatient prenatal records citing maternal or fetal risk factors — for example, preeclampsia, and test results for congenital fetal conditions.

  • Be diligent in documenting all physician/patient interactions, diagnostic test orders and results, pre-operative assessments, intra-operative steps, and the sequence of post-operative events. If you are sued for malpractice, your lawyers can build a stronger case when you provide complete case documentation.

Need Medical Malpractice Insurance for Your OBGYN Practice? SURGPLI can Help.

Our experienced SURGPLI insurance brokers save OBGYNs time and effort by researching and recommending your best options for malpractice insurance coverage, rates, and carrier. Get a fast quote or call 1-800-969-1339

SURGPLI is a division of MEDPLI, an independent insurance brokerage that specializes in making medical malpractice insurance simple for doctors.

Max Schloemann

About the Author

Max Schloemann is a medical malpractice insurance broker, focused on helping physicians secure Medical Professional Liability coverage. He helps Doctors and Surgeons, as well as Physician Assistants, Nurse Practitioners, and healthcare entrepreneurs launch new medical practices across the country. Max graduated Magna cum Laude from Southern Illinois University College of Business and was named the Outstanding Management Senior. Max’s career in medical malpractice insurance began in 2008 with an industry-leading firm. Max founded SURGPLI in 2023 to help surgeons navigate the complexities of medical malpractice insurance in the new era of healthcare. Max’s wife, Kristen, a Physician Assistant, and their 4 kids (plus 1 dog) enjoy hiking, golf, and cooking.

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OB/GYN Specialists: How to Proactively Manage Malpractice Risk2024-02-29T00:00:25+00:00

SURGPLI is a division of MEDPLI, an independent insurance brokerage that makes medical malpractice insurance simple for doctors. SURGPLI helps doctors with surgical specialties find the best medical malpractice insurance that fits their needs and their budget.

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